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` <br />�__ _ <br />_.�r.r.w+....�._.._.�•��.._"'_---��__�"_"___ _�.�-_`_ . <br />_ "__._._.._. . :,*, �. �. Ycs Maybc No <br />. .. ' ti y '� . ..._ <br />i <br />(19) Recrca[fon. Will the proposal result in an impact upo�. the quali[y � <br />or quantity oE existing recreational opportunities? . ._— <br />• Explanation• . -� <br />(20) Archeological/Historical. Nill the proposal result in an al[eration � <br />of a significant archeological or historical site, struc[ure, object <br />or buildin�? -- '-- <br />Explanation: <br />III. SIGNATURE , <br />I, the undersigned, state that to the best of my knowledge Che above i.niormation is <br />ttue and comple[e. It is understood that the lead agency may withdraw any declaration nf non— <br />significance that it might issue in reliance upon this checklist should there be any misrepresen— <br />tatioa or lack of full disclosure on my part. <br />� <br />' �• ' Proponent: _ — <br />• � • �}GFN7� For� ownK-� <br />IV. DECLARATION OF RESPO\SIBLE OFFICIAL: � <br />The above described project is a major action with (significant, insignificant) <br />impact and (will, caill not) require an Environmental Impact StatemenL•. <br />a <br />Responsibl.e Of.ficial. <br />0 <br />